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Preserving Tooth Structure Natural tooth structure is irreplaceable….. THINK HARD before you cut ! Your replacement will never be as good Your replacement will never be as good The tooth will become weaker The tooth will become weaker You are reducing the patients options You are reducing the patients options There is more to go wrong in future There is more to go wrong in future You will probably be shortening the life of this tooth, and possibly the WHOLE dentition You will probably be shortening the life of this tooth, and possibly the WHOLE dentition Practice true CONSERVATIVE DENTISTRY

12
Saving Enamel Where do the enamel prisms run ? Can we leave unsupported enamel If so under what circumstances ? Where can we preserve enamel ? Incisally Prevent class 3 turning to class 4 if possible Marginal ridge tunnel prep or sideways prep Interproximally Palatal approach to Class 3 Just enough for matrix on Class 2 Gingivally Conserve margin, keep supragingival

18
Repairing Old Fillings fillings never get any smaller each time you replace them….. So think before you drill and refill Can the old filling be repaired ? Is there hidden caries Is there hidden caries Is the whole structure compromised Is the whole structure compromised Are the aesthetics poor Are the aesthetics poor If NO, consider repair rather than replacement

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Temporary or Provisional Temporary filling- short term only Prevents ingress of food and saliva Prevents ingress of food and saliva Protects vital tooth structures Protects vital tooth structures Prevents tooth movement Prevents tooth movement Allows healing of painful tooth Allows healing of painful tooth May need to be aesthetic (but not too good) May need to be aesthetic (but not too good) Patient must understand the need to return, and what will go wrong if they dont